Disease/Drug of interest:

Use of Vancomycin on Methicillin-Resistant Staphylococcus Aureus

MRSAImage.jpg

Fig 1. Beginnings of MRSA infection

Motivation and Background:


Not every fight in the medical field is one that can be feasibly and effectively won. We have succeeded before with the eradication of smallpox, and we have made leaps and bounds through the use of antibiotics on the path of improving quality of life and life expectancy. This use of antibiotics, though, has given the scientific and medical community a new battle.

Antibiotics are used to fight bacterial infections that may compromise a susceptible person's health. Due to how quickly bacteria can evolve, antibacterial resistance can become more common over time. In the case of Methicillin-reisistant staphylococcus aureus, garden variety staphylococcus developed an immunity to various forms of common antibiotics through mutation and evolution.

Nobody is safe. MRSA has been seen in healthy people who have not been hospitalized, and funding is needed to continue research into what makes MRSA become more antibacterial resistant and find new antibiotics that work against it.





Target Information:


Vancomycin works by halting the process of the creation of the bacterial cell wall. The target of Vancomycin in MRSA is peptides that contain d-alanyl-d-alanine by binding to the free carboxyl end and preventing the wall from being formed [12].
Dalanyldalanine.png
Fig 2. Rendering of D-Alanyl-D-Alanine
Size: The average mass of D-Alanyl-D-alanine is 160.17116 and it is an uncharged molecule [15]. The molecule, a component of bacterial peptidoglycan is an important target for many antibacterial drugs, including vancomycin.
Function: The regular function of D-alanyl-D-alanine is to be a structural component, and help form the bacterial cell wall, but when it is exposed to Vancomycin it is unable to form the bonds necessary to complete the cell well. This makes the MRSA, or other bacterium, susceptible to immune response.

Drug Information:


Schematic figure of drug:
Vancomycin.png
Fig 3. Schematic Structure of Vancomycin
Formula:
C66 H75 Cl2 N9 O24


Molecular weight: 1449.25 g/mol
CAS Number: 1404-90-6


Delivery method:
The preferred delivery method for vancomycin is intravenously, largely due to the poor absorption of orally consumed vancomycin.

Side effects:
The side effects include Fever and rash (1%- 3%), Phlebitis (13%), Nephrotoxicity (5%), Neutropenia (2%), Red Neck/man syndrome (Erythema, pruritis, hypotension, angioedema)

Other names:
The drug has had many names along its lifespan including Diatracin, VANCO-cell, Vancocin, Vancocin CP, and Vancocine as well as many other accepted alternative names.


Maker or company:

The patent to vancomycin was originally owned by Eli Lilly and company, however the patent has since run out and generics are widely available.
Clinical Trials Info:
There are 21 completed clinical trials on record with results, and 90 studies related to the combination of vancomycin and MRSA in progress.


Origin:

A search was made in the 1950’s to find a compound that was effective in treating penicillin resistant staphylococcal infections. Few options were available and so Eli Lilly and Company started the search for an effective alternative. In 1952, an isolated sample of Streptomyces Orientalis produced a substance that was effective against gram-positive organisms. Quickly, the company set their sights on this compound 05865 as a potential new antibiotic. After positive test results and confirmation from outside labs regarding the effectiveness of the antibacterial qualities of compound 05865, testing began to confirm safe use in humans. In the preliminary clinical trials, compound 05865, now named Mississippi Mud due to its brown color, showed promise. Upon further purification, the name of Vancomycin, a derivative of the word Vanquish, was settled on for the compound.
A multitude of alternatives are available for use including Linezolid, Tigecycline, Glycopeptides, Daptomycin, Iclaprim, Ceftobriprole and Ceftaroline, however the clinical validity of these compounds has yet to be defined[10]. Due to the nature of MRSA, there are very few compounds effective against it. Vancomycin, as a general antibiotic, can be used to treat a multitude of bacterial infections and septic conditions